Health plans and death plans

by Alexander Cockburn

Medicine is nothing but a social take a bit more exercise, science. Politics is nothing but and sometimes live medicine on a large scale.” – longer. The poor get fatter by Alexander Cockburn Rudolf Virchow, reflecting on the and fatter. A real health revolutions of 1848 in Europe. plan would start with pub- columnist The first illusion to chase off lic executions of the top the stage is that the great debate here has had much to do with thousand CEOs and owners of the major food companies and health. So far, as public health is concerned, many of the big- fast food franchises. It would continue with serious penalties gest battles were fought and won a hundred years ago, at the for health workers not washing their hands or merely holding end of the nineteenth century, with better nutrition, birth con- them under the tap without using soap. trol, the change from wool to cotton clothing, the introduction The plagues of America today are beyond the reach of the of modern sanitation in the urban environment and — most modern medical system, and that system is itself a peculiarly important — clean water.

Between 1900 and 1973, American life expectancy went from 47 to 71, but most of this rise had taken place by 1949, when the average life span reached 68. Much of the upward curve could be attributed to improved survival rates for infants and young people. Prohibition helped, since people drank less alcohol, ate more, and hence TB rates dropped sharply, well before the introduction of sulfa drugs. Health in America is class-based, naturally. The poor die sooner, starting with black men who tend to drop dead in their middle 60s, usually from stress and diseases consequent on diet. The better-off folk drink less than they did in the 1950s, take a bit more exercise, and sometimes live longer. The poor get fatter and fatter. A real health plan would start with public executions of the top thousand CEOs and owners of the major food companies and fast food franchises. It would continue with serious penalties for health workers not washing their hands or merely holding them under the tap without using soap. The plagues of America today are beyond the reach of the modern medical system, and that system is itself a peculiarly outrageous example of antisocial imperatives: high technology health care which serves fewer and fewer people. Part and parcel of this system are the drug companies, working in concert with the hospitals and insurance industry. Doctors have long since been shoved to the side as major players. Mostly shunned in all this are the major causes of modern disease, which are environmental. Between 70 and 90 per cent of all cancer is environmental in origin. Heart disease and stroke — the largest killers today — are largely caused by hypertension and stress, which are derived from social conditions. America is very efficient in promulgating Death Plans – tobacco, sugar additives, excessive salt, nitrous oxides out of power plant chimneys, nuclear testing in the 1950s, industrial accidents, speed-up at work and lengthening of the working day, rush-hour traffic — launched in the hope of making a buck and protected fiercely until, very occasionally, the mountain of corpses gets too high to be occluded by even the most refined techniques of the PR industry and the most lavish contributions to politicians. Thus it was with tobacco.

Health reform in the 1930s, in the Roosevelt era, came mostly in the guise of the Wagner Act — a better deal for unions and workers — and Social Security. Old people got something to live on in their later years. Health reform in the 1950s and 1960s came with better wages, a shorter working week, more leisure, plus Medicare — the federal health plan for older people — driven through Congress by the most consummately cunning and accomplished politician of the post-war era and maybe of the twentieth century (unless you make the case for FDR), Lyndon Johnson, who really did care about poverty, having seen a lot of it up close in Texas. Since then, we’ve gone nowhere. Nixon declared war on cancer and founded the Environmental Protection Agency — but corporate pollution continued virtually unabated, courtesy of the energy industry and modern, chemical-based agriculture. In 1977, the Senate Select Committee on Nutrition, chaired by George McGovern, issued a splendid special report on recommended dietary goals for the United States. It swiftly provoked the virulent hostility of the medical establishment and the food industry. The neoliberal attack on regulations has been a health catastrophe. Take accidents — injuries and deaths — at the work place. Because of under-reporting, the number of injured workers every year is likely closer to 12 million than the official 4 million. The 50,000 to 60,000 who die from occupational diseases each year cannot be a hard estimate; cancer, for instance, doesn’t usually come with a pedigree. The insurance industry, the drug industry, the real estate and finance sector are the most powerful forces in the country. They’ve just got Obama to commit $23 trillion to their enduring welfare. They’re not going to surrender the treasure trove known as healthcare without serious blood-letting on the barricades. They own the Congress. Men like former Democratic Senate leader Tom Daschle spring to do their bidding. So, Obama finally produced a timid compromise, whereby uninsured people would be herded under various health insurance umbrellas with “a public component.” Even if the health industry’s hired man, Sen. Max Baucus, had not deep-sixed the public component, the insurance industry could swallow it like a python swallowing a field mouse. It’s sometimes argued that a decent single-payer system would be functional to US capitalism, since industries like the auto sector would be liberated from the burden of health costs. There are scores of decent policies that would be functional to US capitalism. But the soul of US capitalism is wedded to indecency. For 40 years, every American president has deprecated the powers of government to improve the public weal. Why now should Americans believe that any government-backed “health reform” will do them any good, as opposed to assigning them the appropriate lifespan, relative to their income and contributions to the corporate bottom line, which is what the present system amounts to?

Alexander Cockburn is co-editor with Jeffrey St. Clair of the muckraking newsletter CounterPunch. Copyright 2009